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Tennessee rates for HCPCS 50574

Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $2,290.87 / $4,073.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $645.65 / $1,071.52
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $4,073.80 / $5,888.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $831.76 / $1,348.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,187.76 / $2,187.76 / $2,187.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $776.25 / $1,148.15
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $9,332.54 / $9,332.54
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,073.80 / $4,570.88 / $4,570.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $1,479.11 / $2,884.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $776.25 / $1,230.27